Crude tonsillectomy and local concepts of illness in Kisoro, Uganda: Community perception of gapfura and its treatment

Abstract The practice of crude tonsillectomy (CT), performed by traditional healers for a locally defined illness known as gapfura, has become increasingly common in south-western Uganda. This study describes perceptions of gapfura and examines the intersection of locally defined and biomedical illness. Kisoro District Hospital (KDH) staff (n=55) were surveyed, with 95% reporting that CT caused death, and 60% estimating that recipients died as a result of the procedure. Surveys of community members (n=737) revealed that 95% were familiar with gapfura as a common illness with variable symptoms; syndrome classification categorised 58% of descriptive responses as ‘upper respiratory infection’, while 42% suggested more severe diseases. Although only 26% of community respondents told the interviewer that CT was the best treatment, 47% believed the majority of community members use CT and 43% of those treated for gapfura within the past year received CT. The divergent perceptions of community members and allopa...